How to protect your skin barrier

What does your skin barrier actually do?

Your skin barrier controls water loss and protects against chemicals, microbes and physical harm. Its outermost layer, the stratum corneum, contains dead skin cells held together by lipids, or fats. Those cells and fats work together to limit what passes through the skin. The barrier also relies on proteins, natural moisturizing substances and the skin's slightly acidic surface. Normal skin surface pH is about 4.5 to 5.5. That acidity supports the processes that produce barrier lipids and helps maintain the normal skin microbiome, the community of microorganisms living on your skin. Barrier protection is more than adding water: keeping the protective structure intact matters too.2

How to wash and moisturize without making things worse

1. 1Use lukewarm water rather than hot water. Hot showers remove moisture and natural oils from your skin.
2. 2Choose a mild, soap free, fragrance free cleanser made for sensitive skin. Massage the cleanser on and rinse it off; washing your face is not an endurance event.
3. 3Pat your skin dry with a towel rather than rubbing, which can irritate skin.
4. 4After a shower, apply moisturizer within about three to five minutes to help trap water in your skin. Look for ceramides and cholesterol to support the moisture barrier.
5. 5Use sunscreen every day. Choose a product you like enough to use consistently.

Cold weather can bring dryness, redness and itching, so adjust more than your face cream. Choose fragrance free body wash and moisturizer, and switch scented laundry detergent and fabric softener to a free and clear version. Clothing and bedding touch your skin too. Use a humidifier in the evening during cold weather. For body care, the useful sequence is lukewarm washing, gentle towel drying and prompt moisturizing, rather than a hot shower followed by waiting until your skin feels dry.3

What should you look for in a moisturizer?

Barrier creams help maintain the skin's physical barrier, protect against irritants and prevent drying. Their ingredients do different jobs. Choose a moisturizer by what your skin needs, not by how many times the packaging says "barrier".4

Apply barrier creams sparingly and reapply as needed. Some remain on skin for several hours, including after gentle washing. Most should not go directly onto broken skin. Some occlusive creams can aggravate facial acne, and preservatives, fragrances or other ingredients can cause an allergic skin reaction. A richer cream is not automatically the right choice for every face.4

Does niacinamide help protect the barrier?

Niacinamide is a form of vitamin B3 that may improve the skin's lipid barrier, helping retain moisture and keep irritants out. It is available in cleansers, moisturizers and serums, so a separate serum is one option rather than the only way to use it. Most skincare products contain 5% niacinamide or less. If your skin is sensitive, start slowly with a low concentration. Niacinamide can generally be used once or twice daily after gentle cleansing. You can apply a serum after moisturizer or combine the serum with moisturizer and apply them together to the face and neck.5

Before trying niacinamide, apply a small amount to your forearm and wait 24 hours to check for a reaction. Although usually gentle, niacinamide can cause itching, redness, mild burning or an allergic reaction. Check what is already in your routine before adding another product, because the bottles do not coordinate their schedules. Avoid using too many niacinamide products at once.5

Should you exfoliate while protecting your barrier?

Avoid aggressive scrubbing and over exfoliation. For skin that tolerates exfoliation, a mild alpha hydroxy acid is a gentler option than abrasive microbeads. Rosacea changes that advice: stop exfoliating and avoid glycolic and lactic acids. Do not pick pimples; picking causes skin trauma and can lead to inflammation and scars.16

What changes if you have rosacea?

For rosacea, cleanse gently morning and evening with your fingertips, not a washcloth or sponge. Rinse thoroughly and pat dry. If you use rosacea medication, apply it before moisturizer. Wait until your face is dry before moisturizing to reduce burning or stinging. Moisturizer matters even when skin is oily. Choose fragrance free rather than unscented products, and favor a cream over a lotion or gel. Avoid toners and astringents, along with alcohol, camphor, menthol, sodium lauryl sulfate and urea. An ingredient useful in a general moisturizer can still be unsuitable for rosacea.6

Sun protection matters throughout the year, including cloudy days. For rosacea, choose broad spectrum, water resistant sunscreen with SPF 30 or higher, and cover exposed skin. Seek shade and wear protective clothing, a wide brim hat and sunglasses with UV protection. If sunscreen irritates, try a fragrance free formula containing zinc oxide, titanium dioxide or both. Tinted or micronized mineral sunscreens can help avoid a white cast.6

Protect your hands from repeated washing and wet work

For dyshidrotic eczema, which affects hands or feet, use a fragrance free cream or ointment rather than lotion. Moisturize after washing and whenever skin feels dry. Remove rings before washing, moisturizing and sleeping; trapped dampness beneath a ring can trigger a flare. Wash gently with lukewarm water and a mild cleanser, avoiding antibacterial and deodorant soaps. Protect your hands before contact with water, detergents or household cleaners. For wet work, wear cotton gloves beneath waterproof gloves to help prevent irritation. Avoid scratching, overheating and known irritants. If the trigger is unclear, a dermatologist can arrange testing to identify what you need to avoid.7

How do you know the barrier needs help?

Dryness, flaking, roughness, itching, sensitivity and stinging with skincare can accompany barrier damage. If an underlying skin condition is involved, work with a dermatologist. Barrier recovery slows with age, and benefits from changed habits can take three to four months to appear. For broken skin around a pimple, ease back on acne treatments and focus on gentle care while it heals.1